Diabetes mellitus is a chronic endocrine disorder characterized by disturbance of all types of metabolism on the background of an absolute or relative insulin deficiency. Metabolic disorders that occur with diabetes, negatively affect the state of internal organs, which is why diabetes mellitus often develops in such a state as diabetic nephropathy. One of the consequences of diabetic kidney disease is anemia that occurs in most patients with this disease. In this article we would like to tell about the causes, the importance and principles of treatment of anemia in patients with diabetes mellitus.
What is diabetes?
Diabetes is an endocrine disorder that is caused by absolute or relative deficiency of insulin. What does this mean?
Insulin - a hormone in our body, which regulates the exchange of carbohydrates (glucose) lipids and proteins. Insulin is produced by the pancreas in response to raise blood glucose levels (eg after a meal). Once in the blood, insulin is spread throughout the body, reacts with the cells and enables you to capture and process glucose. Thus, insulin lowers blood glucose and tissue nutrition (some tissues of the body is not able to capture in the absence of glucose, insulin). The cause of diabetes is insulin deficiency. Insulin deficiency may be
absolute - that is, the pancreas produces too little insulin (or not produce it). Absolute insulin deficiency occurs in diabetes mellitus type I.
relative - when produced in normal amounts of insulin can not provide adequate glucose metabolism. This situation is observed in type II diabetes, when physiological amounts of insulin can not provide the decrease in blood glucose levels due to reduced tissue sensitivity to insulin itself (this phenomenon is called insulin resistance).
Why diabetes leads to kidney impairment?
With inadequate treatment and long-term increase in blood glucose levels, diabetes leads to significant damage of internal organs. The first of diabetes affects the small blood vessels of arterioles and capillaries that feed blood, all organs and tissues of the body. In patients with diabetes (long-term preservation of high blood glucose levels) the walls of the arterioles are saturated fat and carbohydrate complexes, which in turn leads to cell death in the walls of these vessels is the widening of the connective tissue in them. The affected arterioles are closed, and fed their body begins to suffer from lack of oxygen and nutrients. Renal disease in diabetes (diabetic nephropathy) is developing by this mechanism. Massive destruction of the renal vessels with diabetes leads to the death of a working kidney tissue and replacing it inactive connective tissue. With the development of nephropathy, the kidneys gradually lose the ability to filter blood and form urine - with chronic renal failure. Today, more than half of all cases of chronic renal failure caused by the problem of diabetes.
What relation to diabetes has anemia?
Anemia is a condition in which blood is reduced red blood cells and hemoglobin.
As you know, in our body blood cells are formed in the bone marrow. However, for the red marrow was working, he should get a definite signal in the form of the hormone erythropoietin. Erythropoietin is produced by special cells in the kidneys. In diabetic nephropathy (see above) not only kills kidney cells involved in blood filtration, but also the cells that produce erythropoietin, so in conjunction with chronic renal failure in diabetic patients develop anemia (lack of erythropoietin leads to the termination of the bone marrow).
In addition to lack of erythropoietin in the pathogenesis (development) of anemia in patients with diabetes is the role of iron deficiency and chronic protein loss accompanying renal failure.
What is the impact on the state of anemia in patients with diabetes? According to recent research, for chronic renal failure that developed against the background of diabetic nephropathy complicated by anemia in more than half the cases.
Anemia significantly reduces the quality of life in patients with diabetes mellitus. Against the background of anemia a decrease in appetite, physical abilities, intellectual, and sexual function of patients. People with diabetes with anemia are at greater risk of developing cardiovascular disease, as is likely, anemia is an independent factor contributing to the malfunction of the heart and blood vessels.
How to carry out the treatment of anemia in patients with diabetes? Unlike the cases of anemia caused by iron deficiency or vitamin (iron deficiency anemia, anemia with a deficit of vitamin B12 and folic acid), and anemia that occurred against the background of renal failure in patients with diabetes, not only to treat vitamin and mineral preparations and without adequate treatment can take a very severe form.
How to carry out the treatment of anemia in patients with diabetes?
Given that the main factor in the development of anemia in patients with diabetes is a lack of erythropoietin in its treatment used medications containing erythropoietin.
Erythropoietin - a complex organic compound of the carbohydrate-protein nature. Carbohydrate component of the molecule of erythropoietin may be of two types: alpha and beta (hence the name drug erythropoietin). Erythropoietin for anemia treatment with recombinant get it, that is to synthesize a bacteria, which were introduced human genes that encode the structure of erythropoietin. During the preparation of drugs erythropoietin treatment is repeated, which allows to minimize the incidence of adverse reactions.
Diabetics with diabetic nephropathy should enter with a decrease in erythropoietin hemoglobin level below 120 g / l (ie, early anemia), the ineffectiveness of other treatments (eg, iron). Early treatment with erythropoietin can slow the development of angiopathy (damage small blood vessels), and, consequently, renal disease, which improves the prognosis of the disease and facilitate its flow.
Patients with diabetes, erythropoietin is administered in two ways: intravenously and subcutaneously. Standard injection frequency - 3 times a week. Recent studies in the treatment of anemia in patients with diabetes showed that subcutaneous injections of erythropoietin is not as effective as intravenous, which greatly simplifies the process of treatment (patients can self-perform the injection), and the frequency of injections can be reduced to 1 time per week, subject to the introduction of triple dose.
To increase the effectiveness of treatment of anemia in patients with diabetes, injections of erythropoietin supplement with iron.
Prevention of anemia in patients with diabetes mellitus
We have already mentioned that the diabetic nephropathy, chronic renal failure and, consequently, anemia, most often develop in diabetic patients not taking medication or in patients whose treatment does not ensure the maintenance of normal blood glucose levels. Therefore, the main measures to prevent anemia in patients with diabetes are:
• Earlier access to a doctor at the first symptoms of diabetes, or immediately after the detection of diabetes through a blood test;
• Strict adherence to prescribed treatment (antidiabetic drugs, insulin) and diet in the first days of illness;
• Regular self-monitoring: checking blood glucose levels, the correction of the treatment regimen with your doctor.
• Avoid bad habits - can significantly reduce the risk of cardiovascular disease and diabetes makes it easier for;
• Weight loss (for obese people) - can not only relieve for diabetes, but also to remove it. In addition, weight loss has a positive effect on the course of other diseases related diabetes (hypertension, coronary heart disease, etc.);
In Western countries, diabetes has long ceased to be considered "incurable disease" or "sentence". Thanks to modern possibilities of control of blood glucose (insulin preparations, antidiabetic drugs) diabetes was seen as a "special way of life", not a disease. Indeed, compliance with treatment regimens and streamlined diet can compensate for a lack of insulin for decades, without causing any complications of diabetes.
Treatment of anemia in patients with diabetes should be mandatory, since anemia is not only lowers the quality of life in patients with diabetes but also accelerates the development of the disease and its complications. At the moment the main problem of drug use erythropoietin to treat anemia in patients with diabetes is a high cost of drugs themselves.
What is diabetes?
Diabetes is an endocrine disorder that is caused by absolute or relative deficiency of insulin. What does this mean?
Insulin - a hormone in our body, which regulates the exchange of carbohydrates (glucose) lipids and proteins. Insulin is produced by the pancreas in response to raise blood glucose levels (eg after a meal). Once in the blood, insulin is spread throughout the body, reacts with the cells and enables you to capture and process glucose. Thus, insulin lowers blood glucose and tissue nutrition (some tissues of the body is not able to capture in the absence of glucose, insulin). The cause of diabetes is insulin deficiency. Insulin deficiency may be
absolute - that is, the pancreas produces too little insulin (or not produce it). Absolute insulin deficiency occurs in diabetes mellitus type I.
relative - when produced in normal amounts of insulin can not provide adequate glucose metabolism. This situation is observed in type II diabetes, when physiological amounts of insulin can not provide the decrease in blood glucose levels due to reduced tissue sensitivity to insulin itself (this phenomenon is called insulin resistance).
Why diabetes leads to kidney impairment?
With inadequate treatment and long-term increase in blood glucose levels, diabetes leads to significant damage of internal organs. The first of diabetes affects the small blood vessels of arterioles and capillaries that feed blood, all organs and tissues of the body. In patients with diabetes (long-term preservation of high blood glucose levels) the walls of the arterioles are saturated fat and carbohydrate complexes, which in turn leads to cell death in the walls of these vessels is the widening of the connective tissue in them. The affected arterioles are closed, and fed their body begins to suffer from lack of oxygen and nutrients. Renal disease in diabetes (diabetic nephropathy) is developing by this mechanism. Massive destruction of the renal vessels with diabetes leads to the death of a working kidney tissue and replacing it inactive connective tissue. With the development of nephropathy, the kidneys gradually lose the ability to filter blood and form urine - with chronic renal failure. Today, more than half of all cases of chronic renal failure caused by the problem of diabetes.
What relation to diabetes has anemia?
Anemia is a condition in which blood is reduced red blood cells and hemoglobin.
As you know, in our body blood cells are formed in the bone marrow. However, for the red marrow was working, he should get a definite signal in the form of the hormone erythropoietin. Erythropoietin is produced by special cells in the kidneys. In diabetic nephropathy (see above) not only kills kidney cells involved in blood filtration, but also the cells that produce erythropoietin, so in conjunction with chronic renal failure in diabetic patients develop anemia (lack of erythropoietin leads to the termination of the bone marrow).
In addition to lack of erythropoietin in the pathogenesis (development) of anemia in patients with diabetes is the role of iron deficiency and chronic protein loss accompanying renal failure.
What is the impact on the state of anemia in patients with diabetes? According to recent research, for chronic renal failure that developed against the background of diabetic nephropathy complicated by anemia in more than half the cases.
Anemia significantly reduces the quality of life in patients with diabetes mellitus. Against the background of anemia a decrease in appetite, physical abilities, intellectual, and sexual function of patients. People with diabetes with anemia are at greater risk of developing cardiovascular disease, as is likely, anemia is an independent factor contributing to the malfunction of the heart and blood vessels.
How to carry out the treatment of anemia in patients with diabetes? Unlike the cases of anemia caused by iron deficiency or vitamin (iron deficiency anemia, anemia with a deficit of vitamin B12 and folic acid), and anemia that occurred against the background of renal failure in patients with diabetes, not only to treat vitamin and mineral preparations and without adequate treatment can take a very severe form.
How to carry out the treatment of anemia in patients with diabetes?
Given that the main factor in the development of anemia in patients with diabetes is a lack of erythropoietin in its treatment used medications containing erythropoietin.
Erythropoietin - a complex organic compound of the carbohydrate-protein nature. Carbohydrate component of the molecule of erythropoietin may be of two types: alpha and beta (hence the name drug erythropoietin). Erythropoietin for anemia treatment with recombinant get it, that is to synthesize a bacteria, which were introduced human genes that encode the structure of erythropoietin. During the preparation of drugs erythropoietin treatment is repeated, which allows to minimize the incidence of adverse reactions.
Diabetics with diabetic nephropathy should enter with a decrease in erythropoietin hemoglobin level below 120 g / l (ie, early anemia), the ineffectiveness of other treatments (eg, iron). Early treatment with erythropoietin can slow the development of angiopathy (damage small blood vessels), and, consequently, renal disease, which improves the prognosis of the disease and facilitate its flow.
Patients with diabetes, erythropoietin is administered in two ways: intravenously and subcutaneously. Standard injection frequency - 3 times a week. Recent studies in the treatment of anemia in patients with diabetes showed that subcutaneous injections of erythropoietin is not as effective as intravenous, which greatly simplifies the process of treatment (patients can self-perform the injection), and the frequency of injections can be reduced to 1 time per week, subject to the introduction of triple dose.
To increase the effectiveness of treatment of anemia in patients with diabetes, injections of erythropoietin supplement with iron.
Prevention of anemia in patients with diabetes mellitus
We have already mentioned that the diabetic nephropathy, chronic renal failure and, consequently, anemia, most often develop in diabetic patients not taking medication or in patients whose treatment does not ensure the maintenance of normal blood glucose levels. Therefore, the main measures to prevent anemia in patients with diabetes are:
• Earlier access to a doctor at the first symptoms of diabetes, or immediately after the detection of diabetes through a blood test;
• Strict adherence to prescribed treatment (antidiabetic drugs, insulin) and diet in the first days of illness;
• Regular self-monitoring: checking blood glucose levels, the correction of the treatment regimen with your doctor.
• Avoid bad habits - can significantly reduce the risk of cardiovascular disease and diabetes makes it easier for;
• Weight loss (for obese people) - can not only relieve for diabetes, but also to remove it. In addition, weight loss has a positive effect on the course of other diseases related diabetes (hypertension, coronary heart disease, etc.);
In Western countries, diabetes has long ceased to be considered "incurable disease" or "sentence". Thanks to modern possibilities of control of blood glucose (insulin preparations, antidiabetic drugs) diabetes was seen as a "special way of life", not a disease. Indeed, compliance with treatment regimens and streamlined diet can compensate for a lack of insulin for decades, without causing any complications of diabetes.
Treatment of anemia in patients with diabetes should be mandatory, since anemia is not only lowers the quality of life in patients with diabetes but also accelerates the development of the disease and its complications. At the moment the main problem of drug use erythropoietin to treat anemia in patients with diabetes is a high cost of drugs themselves.
I totally agree with the point of view of author, specially point of treating anemia should be mandatory.
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